Not compared to placebo arm (Maybe doing nothing would have produced the same results and patients’ delirium would resolve naturally)

Haloperidol was genrally safe

No strong evidence to support general use of haloperidol or alternatives to treat delirium in hospitalized older adult patients in terms of severity, duration, LOS, mortality

No difference in delirium severity, duration, length of stay or mortality

Cholinesterase inhibitors:

do NOT initiate to prevent or treat delirium without any other indication

Anti-psychotics:

If severely agitated or distressed and risk of harm to self/others AND other behavioural interventions have failed, may use antipsychotics at LOWEST dose/SHORTEST duration

scarcity of quality evidence

no difference between different antipsychotic agents

Atypical APs may reduce duration of delirium in ICU
(QTP added to Haldol in 1 study)

Benzodiazepines

do NOT use 1st line to treat agitated post-op delirium in patients at risk of harm to self/others – may worsen delirium!

only role is with BZD-withdrawal

Benzodiazepines and antipsychotics have no role ESPECIALLY in patients with hypoactive delirium (exception may be in patients with hallucinations; however, these hallucinations may be comforting to have)

Dexmedetomidine (Continuous IV infusion):

may be used rather than BZD infusions to treat and reduce duration of delirium in ICU

This is a very useful session as my BC Case Wide Presentation is coming up in October.Everything was laid out very clearly and Sally Waignein provided great tips on preparing and executing case presentations!

✔ The Great Translators: Patient Advocacy

Take Home Points:

Introduce yourself and your role when doing bed-side rounds, etc.

Or go back to patients after rounds to introduce yourself and your role

Making time to listen and slowing down

Making connections with patients and building rapport, instead of going straight to the medical issues

Performing careful discharge counselling

Steps:Knock, Introduce yourself, Describe what you are there to do, Sit down & Slow down

Ask patients if this is a good time for you?

Asking:
[Do you have “some” questions?] is a more positive question than [Do you have “any” questions?]

✔ Liver Function Tests:

Frank was the first of the residents to present on an Academic Day Seminar, and he did a great job on guiding us through liver function tests!